As you may have heard, the American Medical Association (AMA) recently stated that they now classify obesity as a disease. According to Ardis D. Hoven, president of the AMA, “the AMA is working to reduce the burden of preventable disease to ensure health, wellness and well-being for all Americans” 1.
Before I go any further, let’s define obesity. There is a distinction between overweight and obese; this distinction is marked by BMI (body mass index). Overweight is classified as having a BMI between 25 and 29.9 whereas obesity is a having a BMI of 30 or above. There are also classes of obesity, but I will not define all of those here. These definitions are for adults only.
Children are classified differently because they are growing at rapid rates, thus their body composition various on a regular basis. Children’s BMI is defined using a growth chart. A BMI on the growth chart between the 85th and 95th percentile is overweight, while a BMI at or above the 95th percentile is obese.
The Centers for Disease Control and Prevention (CDC) report that 35.7% of American adults are obese. That’s over 1/3 of American adults! Colorado has the lowest obesity prevalence at 20.7% while Mississippi has the highest at 34.7%. Though some studies show that economic and education status impact obesity trends, the CDC reports that between 2007 and 2008, obesity prevalence increased in adults at all income and education levels 2. American children and teens aged 2-19 have a lower rate of obesity at 17%. However, considering their age and need for healthful growth, this is quite alarming 3. Moreover, this is a time in which healthful habits can be learned, setting the path for the rest of one’s lifespan.
Multiple factors contribute to obesity. People can have a genetic predisposition to and/or a family history of obesity. Other factors that may lead to this problem include, certain medications, sleep patterns and/or disorders, medical problems (hypothyroidism, for example), anxiety and stress levels/disorders, hormone imbalances (insulin and leptin, to name a few), gut health, food availability relating to both quantity and quality (*I believe quality of food in America is a major factor*), exercise habits, time and motivation, and accountability and support. You may notice that I did not specifically mention metabolism, as these aforementioned factors contribute to metabolism, thusly leading to overweight and obesity.
Undoubtedly, there are pros and cons to labeling obesity as a disease. According to Hoven, “diet and exercise may not be enough to get to a healthy weight, and medication or surgery may be needed” 1. Granted, surgery can be beneficial and in fact has been shown to improve and in some cases, reverse diabetes, it is also a last resort. This is one of my fears—that labeling obesity as a disease may lead to a greater push for unnecessary drug therapy and surgery as opposed to improved diet and exercise. Lack of diet and exercise support is a huge problem in dealing with weight management.
A greater push for drugs and surgery could come with a spike in healthcare costs. Additionally, these types of treatments may help resolve some of today’s patients who struggle with the problem, but it may lack the essential focus on prevention of the problem. Obesity is treatable and preventable. We must focus on the prevention, which is something that America truly struggles with. A raise in healthcare costs with little or no positive long-term outcomes is only aggravating the already existing problem.
Perhaps this label will help registered dietitians receive reimbursement for weight management counseling as well as for preventative care. However, I find this to be a lofty hope. As I have been reading through articles and statements over the past month, I have hardly heard or seen mention of dietitians. I have read article upon article mentioning doctors, surgeons, pharmacists, and government-funded programs. But RD’s are often overlooked, unfortunately.
When it comes to recommending healthy nutritional habits, doctors often lack the knowledge of (and sometimes interest in) reputable sources. The CDC website lists resources including ChooseMyPlate.gov and the Dietary Guidelines for Americans 2010. It also provides a link to the USDA brochure “Let’s Eat For the Health of it.” These are a few resources that some RD’s may recommend, but this is where I begin my personal perspective…
This brochure suggests that one cut back on solid fats (butter, cream, coconut oil, chicken fat) while using oils instead (canola, corn, soft margarine, cottonseed). Canola and corn are 2 of the most common GMO crops in the American food supply. Suggesting that people consume any canola oil over any butter or coconut oil is not something I support. Additionally, this USDA brochure recommends selecting fat-free or low-fat milk, yogurt, and cheese. When are we going to learn that choosing low-fat and fat-free products are not the answer? Furthermore, I do not suggest that a person choose fat-free cheese. Oftentimes, there are chemicals and binders added to fat-free cheeses that are not needed in the full fat version.
The “Let’s Eat For the Health of it” brochure states: “Everyone has a personal calorie limit…people who are successful at managing their weight have found ways to keep track of how much they eat in a day, even if they don’t count every calorie.” It goes on to suggest that you “think before you eat…is it worth the calories?” Well my goodness, if that isn’t the prequel to a disordered eating pattern I don’t know what is! And again, it states that you ought to check calorie counts when you’re eating out 4. Calories calories calories!! Is that all that matters?? I say no no no!
Fat is not bad, calories do not need to be counted, and I truly believe that teaching people to consume a diet that is lower in fat and based on calorie counting will lead to a very unhealthy thought process. Also, it is likely to lead to a diet that is higher in sugar and artificial additives, such as chemical sweeteners, flavors, binders, emulsifiers, and dyes. These are not natural products and can lead to harmed metabolism, especially when consumed for an extended period of time. Let me also mention the importance of a healthy gut. These types of “food” products lead to an imbalance in healthy gut bacteria, thus causing your metabolism to function at an altered level.
So where does this leave us? Well, I do agree that obesity is like many other diseases that are greatly influenced by lifestyle factors—lung cancer, type II diabetes, and heart disease, to name a few. However, this does not mean that we can trust others to guide us to optimal health via medications and surgeries. Those are options and they may be helpful to some patients. However, it is extremely important for individuals to take the necessary steps towards health and balance via nutrition and exercise. Please remember and take to heart this famous Hippocrates quote: “Let food be thy medicine and medicine be they food.”
Obesity, whether labeled as a problem, an epidemic, or a disease is treatable and preventable. Old-fashioned weight loss methods of counting calories and eating a low-fat diet are not the answer, as has been proved over the past decades. Balance and harmony within one’s whole body is a necessity when it comes to overall health and yes, fighting obesity. Weight loss drugs and surgeries are not going to solve the obesity problem across America. That may be the answer for a very select few, but that is not the answer when fighting this epidemic in our country. Please remember that nutrition can heal and prevent this “disease.”
1.) Ardis D. Hoven. “Obesity As a Disease?” HuffingtonPost.com 28 June 2013. Accessed 16 July 2013. http://www.huffingtonpost.com/ardis-d-hoven-md/obesity-as-a-disease_b_3518956.html
2.) Adult Obesity Facts. Centers for Disease Control and Prevention. Atlanta, GA. CDC.gov. 13 Aug 2012. Accessed 16 July 2013. http://www.cdc.gov/obesity/data/adult.html
3.) Data & Statistics. Centers for Disease Control and Prevention. Atlanta, GA. CDC.gov. 11 Jan 2013. Accessed 16 July 2013. http://www.cdc.gov/obesity/data/childhood.html
4.) USDA. “Let’s Eat For the Health of it.” Publication number: Home and Garden Bulletin No. 232-CP. June 2011.
Until next time, happy whole body healing!